Body composition, nutritional status and clinical outcomes in end-stage liver disease

Abstract

The importance of good nutritional status and body composition in patients with end-stage liver disease is central to this thesis. Using CT scans, we determined the body composition of patients who were screened for liver transplantation. Body composition is related to the risk of premature death during the waiting list period, death in the first year after liver transplantation, and length of hospital stay after liver transplantation. Patients with low muscle quality had a lower 6-minute walk distance than patients with normal muscle quality, which increases the risk of death during the waiting list period. In Dutch institutions, at least one tool is usually available to measure body composition, and the relevance of these measurements is known to dieticians and hepatologists, although barriers in terms of reliability, time investment, costs, knowledge and skills are experienced. Measuring resting metabolism is essential for determining energy requirements; formulas carry a higher risk of overestimating or underestimating energy requirements. In men, a negative energy balance is associated with low muscle mass, as is not eating an optimal evening snack. After liver transplantation, in post-liver transplantation diabetes, we investigated in a small case series that Semaglutide injections can help improve blood values, BMI and waist circumference.